| NPI | 1902224553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME136157) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MD472727) |
| 207N00000X Dermatology (Licence: SC 85532) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: PA MD472727) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME136157) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: SC 85532) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: PA MD472727) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME136157) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2023-05-03 |